What Does Hyper-Mobility Mean To You? Does It Cause You Problems?

This weeks Blog has been inspired by a recent influx of people to the clinic who have previously been diagnosed with hyper-mobility syndrome. Sounds scary eh? Not to us. In fact I’m not sure it means anything at all really. Remember anything with syndrome on is the medical professions way of confessing up and saying we don’t really understand this! So in today’s Blog we hope to dis-spell some myths about hyper-mobility as a cause of your pain.

Definition Of Hyper-Mobility

“Hyper-mobility is defined as an abnormally increased range of joint motion due to excessive laxity of the constraining soft tissues.” According to a definition from Stanford University. I like this. Succinct and to the point. Further attention for those not in the trade should be paid to defining what “soft tissues” are. Basically anything that is not bone. Soft tissues that can affect joints are muscles, fascia, ligaments, tendons and joint capsules.

The same article very importantly goes onto to say that in most cases they term this finding “benign.” This is to say that this clinical finding is not relevant to any symptoms within the body. There are of course some exceptions but I think that goes beyond the scope of the this article!

So Does It Really Exist?

So if in the vast majority of cases the hyper-mobility is termed as “benign” does it have a bearing on the pain you feel? Probably not. I’d like to go back to the definition we used above. I know I’m being unusually pedantic today, but bear with me.

Abnormally is the word I want to look at. Who decides what is abnormal? Sadly, previously, it has been Physiotherapy textbooks which define normal ranges of movement. In fact I believe Physiotherapy students are still tested on what normal range of movement of certain joints is. What a complete waste of time that is! Everyone is so massively different. Should we compare contortionists and gymnasts as shown in the picture to big burly rugby players?

To give you an example we regularly see people with perfectly functional hamstring whose range of movement barely gets to 30 degrees. Equally we see dancers and gymnasts who have a range of movement in excess of 160 degrees. I’ve even seen one lady who can get her leg past horizontal going beyond 180 degrees. Technically this is the definition of hyper-mobile. Did it give her any physical problems, no. Her body had simply adapted to the needs of her profession.

Does Hyper-Mobility Make The Joints Wear?

In a word no. Let’s dis-spell a few myths again. Firstly wear and tear on the cartilage within your joints doesn’t necessarily have to be painful. Cartilage in itself is very poorly innervated by nerves and therefore, by definition, cannot feel much pain. We talk in much more detail about this idea in our previous post Does Arthritis Really Exist. We also talk about more recent research which has shown that the amount of wear and tear on your joints is NOT a predictor for the amount of pain that you feel.

A lovely practical example of that is a client I have been seeing for the last month who has been told by an orthopaedic surgeon that he needs two knee replacements immediately due to the state of his cartilage. 4 treatments in and he’s walking about town pain free and I’m harbouring ambitions that I’ll get him skiing again! Have I changed the cartilage? No. Have I improved the muscle control that gives stability to the joint? Yes.

We can glean further reassurance for another large study which concluded that most wear and tear in joints happens in elite athletes and the morbidly obese. So the rest of us in between should have relatively minimal wear and tear in the grand scheme of things. And even if we’re not, and we have considerable wear and tear on the joints, that in and of itself is not necessarily the cause of our pain.

So coming back to hyper-mobility, even in the most of silly mobile joints even if that does lead to some wear and tear on the cartilage because the joint is literally going too far – it’s still not necessarily the excessive movement in the joint that is holey responsible for your pain experience.

In fact what you choose to believe is more important than what is happening physically. Such is the power of the mind! If you’ve been told by someone in a position of power, say a doctor, surgeon, physiotherapist, sports therapist, anyone that you trust. If they tell you it’s the hyper-mobility that is the problem and there’s nothing that can be done. You believe them and that alters your behaviour to being defensive of the joint or joints which alters your movement patterns which makes things worse.We explore this idea in more detail in our blog on the psychology of pain – 50 Shades of Pain.

One of our biggest challenges as therapists is to change people’s beliefs. We try to do this with our actions and our techniques which show that change can come about quicker than you’d previously thought possible. We also go to great lengths not to make sweeping statements about conditions. So what if you’re hyper-mobile. The key question is what can we do to help you feel less pain?

What Can Be Done About It?

Hopefully you’re with me now in understanding that just because you’re extra flexible in some joints it’s not enough to say that is the sole cause of your pain.

If we go back to our original definition of hyper-mobility we see that it talks about excessive range of movement caused by laxity of soft tissues. Remember soft tissues relating to joints are ligaments, tendons, joint capsules, fascia and muscles. Now what out of that list can we affect?

Ligaments – Traditional wisdom suggests once they’re floppy they’re floppy! Either from previous injury or genetics. One exception is pregnancy, ladies ligaments loosen especially around the time of birth – for obvious reasons. Then become more rigid again in the months after child birth. However, with the world of physiotherapy and bio-mechanics opening itself to the fascia revolution we can argue here that the fact that all ligaments (apart from the cruciate ligaments in the knee) are entirely invested within the fascia and therefore if we affect muscle and fascia we can affect control of the ligaments – let’s not get too involved in this one today or we’ll be here for a while!

Tendons – again very hard to specifically train and strengthen – just speak to someone with a genuine (which is rare) Achilles tendon problem. But again maybe we can affect their function by improving the muscles and fascia to which they belong.

Muscles and Fascia – I’ve grouped these 2 bad boys together because if we affect fascia we affect muscles and vice versa. It is the length-tension relationship of the muscles and fascia that control the positioning in space of the joints. If we can better control the muscles that act across the joint we therefore better control the joint. Hyper-mobile or not. If we can improve function of the muscles and fascia using our box of magic tricks that we use at the clinic then we invariably see a massive change in people’s pain. Have we reduced the range of movement in the joint? No. Have we improved the muscle control around hyper-mobile joints? Probably. Have we removed the pain? Yes.

Conclusion On Hyper-Mobility

Whilst all of this is not an exact science this approach works in the vast majority of cases. Whilst I concede that in rare cases the excessive hyper-mobility of a joint or joints can cause problems in our experience hyper-mobility is massively over diagnosed as the source of people’s pain and in approximately 90% of cases this can easily be remedied with the right course of treatment.

If you’re struggling with an issue you or anyone else has put down to hyper-mobility, or any other condition for that matter, and you’d like to know if we’d be able to help you please give us a call to discuss your condition on or mail at info@BrightonSportsTherapy.co.uk. We’d love to be able to help get you pain free again!

Call us now 01273 921831

Dr Rank gives a medical perspective on the effectiveness of our treatments

Personal Trainer Kirsty - Knee Pain Gone

Dr Knight - Medical Doctor and Triathlete

Carol - Migraines

I have experienced some pain in the back of my knee. I have been to see Jamie and have to compliment his professional knowledge. He has the great ability to explain complex issues. He gave me lots of advise on how to treat my pain with everyday movements. Apart from his expertise, I would like to point out that Jamie is a very approachable and friendly person. I would highly recommend him!

CC

I picked up an IT band knee injury while training for the Brighton marathon this year that prevented me running any more than 5-10k without serious pain. I’d all but given up hope of running the marathon after trying various things to fix it without success. I started seeing Jamie less than 6 weeks before the marathon and after about 3-4 session I was able to run a lot further with much less pain. By the day of the marathon, my knee felt almost completely better, and I ran the whole thing with no knee pain at all! I don’t claim to fully understand everything Jamie does, but it definitely works. Amazing stuff & highly recommended!

BK

I compete in a lot of endurance sports and high impact sports too. I have seen Jamie for a few years now and he is among the very best I have seen (and I’ve seen a few over the years!) Highly recommended.

NL

Meeting Jamie for the first time was a very enjoyable experience, he explained a whole new way of the strains I had been putting on my body through Marathon running, tennis and bad posture, Within 30 mins he was working away and my body started to feel 10 years younger. A completely new and invigorating approach to back and muscles problems that I had battled with over the years.

Jamie is extremely good at getting fast results and you back on track with your exercise routines and he even sets you homework

I would have no hesitation of recommending BST to any one

AB

Jamie knows what he’s doing, though don’t expect traditional physiotherapy. I visited with a calf tear recovery problem after a recommendation by a friend. I couldn’t run without damaging it over and over again. Jamie’s holistic approach had me running again within the month, and I’m still running, building up distance again. While he was at it he’s helped massively with problems with my ankle and shoulder, definitely seek him out if you’re having problems.

SM

This guy knows his onions. After several Ironmans and too many marathons I was looking for someone to activate underused muscle groups and to help me feel less creaky overall. After sessions with BST I felt great and left with a whole new understanding of the human body. Jamie shared a lot of new and interesting insights and gave me a series of treatment that really worked.

SC

As an ultrarunner I approached Jamie Webb with much trepidation, expecting the usual advice to stop running silly distances and I wouldn’t be complaining of injuries. Instead, I was met with complete acceptance of ‘what I do’ combined with consistent ‘work’ on the source of my injuries/complaints. I couldn’t recommend Brighton Sports Therapy highly enough. It has been a joy to finally run pain-free again. My running complaints have ranged from ankle injuries to IT-band trouble, lazy glutes, core and hip stresses and strains … ALL of which I can happily say are currently in the best condition they can be in. Will I stop running? No. But the holistic approach of Brighton Sports Therapy has allowed me to continue, improve and race pain-free. Thank you.

AH

A few months ago as I began to have problems with my right knee, and on some occasions was unable to put weight on it when going up steps or uphill, I asked on Facebook if anyone knew of any good physiotherapists in my area, and I was recommended Jamie Webb. I went along and was assessed, with all aspects of my health taken into account, Jamie diagnosed a muscle imbalance, and immediately began working on releasing muscles in many parts of my body, but strangely (not to him) this had the effect of strengthening the muscles around my knee. I have since completed a 100k non stop walk, plus have trekked round Iceland with no further problems to my knee (or any other part of my poor body). I assure you that if Jamie is given a body suffering in any way from the traumas of sport, he will have you diagnosed, and be working on the problem within the first 30 minutes of your appointment, and you WILL leave after the 1st hour already aware of improvement.

DP

I can honestly say that’s the best money I’ve ever spent! I’d been struggling with a football injury for months and Jamie made a massive improvement in the first session. I’m now able to go into tackles 100% knowing that my ankle will be fine. I no longer need any more treatment, that’s how good things are, but if I do get another injury I know exactly who I’ll be ringing!

AP

Disclaimer: The testimonials above are the opinion of a few of our clients. Results to treatment cannot be guaranteed. We can guarantee we’ll be doing everything we can get you back to your best ASAP.